Effect of Almond Milk Versus Cow Milk on Postprandial Glycemia, Lipidemia, and Gastrointestinal Hormones in Patients with Overweight or Obesity and Type 2 Diabetes: A Randomized Controlled Clinical Trial

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BACKGROUND: Almond milk is often seen as a healthier alternative to cow milk. However, its effect on postprandial glycemia compared to 2% milk is unclear. Here, we compared the postprandial glycemic effect of almond milk versus carbohydrate- or caloric-matched 2% milk, each served with oatmeal to patients with type 2 diabetes (T2D). METHODS: In this crossover, three-way, open-label study, 22 participants (mean age 66 ± 7.4 years, 36% female), with T2D and overweight or obesity, consumed oatmeal served with almond milk (ALM), carbohydrate-matched 2% milk (MLKCRB), or calorie-matched 2% milk (MLKCAL) on separate days and in a random order. The primary outcome was glucose incremental area under the curve for 240 min (iAUC0-240). The secondary outcomes included postprandial serum insulin, glucagon, plasma free fatty acids (FFAs), serum triglycerides, leptin, and gastrointestinal hormones (PYY, active GLP-1, GIP, amylin, cholecystokinin, and ghrelin). RESULTS: We did not find any difference in either the primary endpoint or secondary endpoints between the three groups. However, iAUC0-240 for insulin and glucagon was significantly higher in MLKCRB vs. ALM (FDR = 0.002 and 0.02, respectively). CONCLUSIONS: Almond milk does not offer any additional glycemic benefit over 2% milk and does not differ in its postprandial effects on FFAs, serum triglycerides, leptin, and gastrointestinal hormones over 4 h. Nonetheless, carbohydrate-matched 2% milk elicited greater insulin and glucagon response compared to almond milk, warranting further investigation into its long-term implications.

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